How to Become an ICF/IID Provider

Texas Health and Human Services licenses and Intermediate Care Facilities for Individuals with Intellectual Disabilities for compliance with state and federal laws and regulations. Through these regulatory activities, HHS protects Texas citizens receiving these services.

What is an ICF/IID?

A facility serving persons with an intellectual disability or related conditions licensed under this chapter as described in 26 TAC §551.2 of this chapter (relating to scope) and required to be licensed under the Health and Safety Code, Chapter 252, or the entity that operates such a facility; or, in Subchapters C, D, and F of this chapter, a program provider that must comply with those subchapters in accordance with 40 TAC §9.212 of this title (relating to Non-licensed Providers Meeting Licensure Standards).

ICF/IID Medicaid Bed Allocation

In order to be considered for ICF/IID licensure, the applicant must have an allocation of Medicaid beds. HHSC has created a reallocation process for Medicaid beds that return to the control of the state. Read the rules located at 26 TAC §261.220 that explains the new process.

Becoming Licensed in Texas

ICFs/IID must be licensed to operate in Texas. To become licensed, a location must:

  • Properly complete the license application.
  • Submit appropriate ownership documents.
  • Pass Life Safety Code and health inspections.
  • Be approved by the Licensure and Credentialing Unit.

Process Maps

The following process maps provide an overview of the licensure and certification process.

Types of Applications


An initial application has never been issued an HHS license number to operate in Texas. Changes of ownership are also considered initial applications.

Change of Ownership

A change-of-ownership application happens when the facility changes the tax identification number.


Reactivation application is considered an initial application.


A renewal application for current license holder must be submitted on or before the licensure expiration date. Late fee can apply. Any application submitted after the licensure expiration date will not be accepted.

Increase in Capacity

An increase in capacity application must be submitted for an increase in capacity. A license holder must not increase a facility's licensed capacity without approval from HHS.

Time Frames for Applications

License application for an initial, relocation, renewal or change of ownership:

  • Upon receipt of a license application, the HHS Licensing and Credentialing Unit has up to 30 days to review the application.
  • If HHS receives an incomplete application, the Licensing and Credentialing Unit will notify the applicant in writing of any deficient items in the application. The applicant must respond with complete and correct information within 30 days from the date of notification. If the application is not completed timely, it will be denied.
  • Upon receipt of a complete application and passing recommendations about Life Safety Code and health surveys, the Licensing and Credentialing Unit will issue the license within 45 days.
  • If a location does not complete the application or pass Life Safety Code or health surveys within a timely manner it will be forwarded to the enforcement section for denial.

Licensure Fees

  • The license fee for a three-year initial or renewal license is $225 plus $7.50 for each unit of capacity for which the license is sought.
  • The license fee for a two-year renewal license issued or relating to renewal procedures and qualifications is $150 fee plus $5 for each unit of capacity for which the license is sought. Increase capacity fee: $7.50 for each unit of capacity approved.
  • Change of Administrator: $20
  • Late fee of one half the basic fee will be assessed if the renewal application is submitted less than 45 days before the license expiration date.
  • Decrease in Capacity: No charge

Changes of Information

Change in the Facility Name

If license holder intends to change its name (legal entity or doing business as) but does not undergo a change of ownership, the change must report the name change. Another license will be issued to reflect this change.


A license may not be transferred from one location to another without prior notice to HHS. 26 TAC §551.22.

Changes in Phone Number or Operating Hours

Changes in phone number or operating hours must be submitted in writing as soon as possible.

Fax Number and Email Address

Report as soon as possible.

Changes in Management

Report as soon as possible.

Changes in Controlling Person

Changes in controlling person (stock transfers), as defined in 26 TAC §551.3(13), must be reported as soon as possible.


A license holder must notify HHS in writing about the closure and return the license.


Visit the TULIP website for application forms and instructions. Go to TULIP.

  • License application forms Form 3720, Application for State License to Operate a Long-Term Care Facility. This application applies to initial, relocation, change of ownership, capacity increase, changing administrator or manager or director, update controlling parties, update management companies, and update stock transfer.
  • Form 3725, Licensure Change of Ownership Affidavit. This form must be completed by the incoming and outgoing owner.

Licensing Standards and Statutes

Intermediate Care Facilities for Individuals with Intellectual Disabilities Medicaid Provider Agreement with HHS

As of January 1, 2019, Medicaid contracting for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) is completed through the Contract Administration and Provider Monitoring section of the HHSC Medicaid / CHIP division. For additional information, call 512-438-3390 or email HHSC CAPM NF ICF Contracts.

Submit general questions regarding Medicaid Enrollment via email to TMHP Provider Relations.